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Existing Patient Forms

EXISTING PATIENT FORMS CENTER

Re-Examination Form (existing patients):

Click Here to Download 

Returning Patients (6-12 months):

Click Here to Download




Member Wellness Registration Form - Optional

This form can be filled out to register for access to the member wellness section of our website. You can also sign up for our monthly newsletter to keep up on current health issues and news and events in our office. Click Here to register online! The online newsletter sign-up is also on the right. We look forward to making your experience with our office and website more interactive and rewarding!



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Physical Synergy
340 Post Road
Fairfield, CT 06824
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  • Phone: 203-259-3210
  • Fax: 203-259-3213
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